Depression & the Dental Student

Laura writes about an account of her own experiences with depression during her dentistry degree, and how best to help someone suffering from depression.

Laura is a final year dental student at Peninsula Dental School. She says “I wanted to write an article that properly explained how depression can affect someone, as text books never seem to be able to do so effectively.” “ I think it is important for all health care professionals to have an understanding of how depression can affect people; not just to improve patient care, but so they can recognise the signs and symptoms in peers and colleagues. It is important for people to know that they are not alone and that help is there for them if they need it.”

For the past couple of years I have suffered from varying degrees of depression. As you will know, dental degrees are not exactly a walk in the park. You constantly have to study to ensure you can provide your patients with the best possible care, whilst worrying about hitting targets and finding cases to present in final year. There are exams and assessments every other day, it seems, and heaven forbid you suffer illness and thus fall behind.

As dental students, we all fit certain moulds: perfectionists, high achievers, ambitious individuals. We put so much pressure on ourselves to be the best we can, and this can take its toll. I foolishly tried to hold down a part-time job whilst studying, leading to several months without a single day off. Combining that with a hectic personal life, it was unsurprising that in November last year it all fell apart. In my words: “I broke”. In medical terms, I was suffering from burnout: a combination of exhaustion and depression.

I should have asked for help long before I finally did. I was having difficulty concentrating on academic work; I passed out every night after forcing myself to research whichever topics were in our syllabus for the month, and woke up feeling like I hadn’t slept at all. I stopped socialising; I stopped eating; I stopped caring about my own wellbeing. The only time I was ever really awake and functioning was on clinic.

I felt too scared and embarrassed to ask for help. I was terrified that any absence would put me behind, and any lapse in my academic work would lead to failure of the year. I knew I was depressed, but in my mind a formal diagnosis would cost me my degree. So I kept quiet and pushed on. It was only when my condition worsened to the point of true exhaustion and my hands started shaking, that I asked for help. I couldn’t practise dentistry safely if I couldn’t control my own hands.

Luckily for me, the staff I talked to understood and helped me find the assistance I needed to get back on my feet. After several weeks off clinic and my studies, I was back to being a functional human being. The student with whom I worked on clinic was amazing; she kept an eye on me and offered help and support whenever I needed it. Like I said, I was lucky. Not all universities are as supportive as mine has been.

Health care courses are intense. You spend most of your time thinking about how to help other people, and it can be easy to forget that you are allowed to ask for help yourself. One in three people face depression at some point in their lives, and yet there is still a stigma attached to admitting you are dealing with it. Even if you realise that you need help, the depression convinces you that you are weak if you admit it, and that you will be judged by everyone once they know.

If you’re one of the lucky two thirds of people who haven’t experienced depression, it can be difficult to fully understand what it is like. Let me try to explain.

Depression is draining. It is like having a rain cloud constantly over your head, pouring cold water down your spine. It numbs you, dampening any good or happy thoughts that might try to shine through the gloom. Getting out of bed can seem like the hardest thing in the world. Your limbs feel heavy and immoveable. You can be sat inside your own head, screaming at yourself to get up, but your body just won’t respond. You are a prisoner in your own mind. The negative thoughts take control of you, insulting you, preying on your darkest fears and insecurities. It knows exactly how to put you down; because it is you.

Depression is different every day. Some days can feel normal. Some days can feel like the sky is falling. Other days you feel nothing, and those days can be the worst. It is difficult for others to realise you're depressed, because when you're with them that negative voice in your head is not as loud. You can act normally, and make excuses like “I’m just tired”, or “it’s just stress” if anyone happens to notice your dulled character.

Depression is complex and persistent. Even now, after almost a year, I am not back to normal. I'm still on antidepressants and have more counselling lined up for next semester, but I am improving. Recovery takes time, and it takes help. I am very aware that I have been extremely lucky. My university has been behind me the whole way, ensuring I had the help and time I needed to recover, without penalising me for my absence. Not everyone has this luxury.

Too often, people find only limited help available, and very little in the way of understanding. Depression is still seen by many as a fictional ailment devised by the lazy to gain time off work or benefits. There is no benefit to depression and, in the case of burnout; it often affects the people most conscientious about their work. The days I spend staring at the imperfections in the paint on my bedroom walls are not days of laziness. I physically cannot move. I can't just "snap out of it" or "cheer up", and I'm not just looking for attention.

These misnomers are damaging and difficult for a depressive to fight against. When you can barely summon the energy and the will to get out of bed in the morning, when you're constantly battling yourself, when you're hearing nothing but negativity from yourself, how can you battle everyone else for a chance to be heard and understood?

As health care professionals, we have a duty of care to our patients, and I do not doubt for even a second that any of you would dismiss a patient who tells you they have depression or anxiety. However, it is much easier to overlook or become frustrated with a friend or colleague suffering from the same ailments. Patience, understanding, and just “being there” for someone will help more than you realise. It takes a lot of courage and drive to pull yourself out of depression, but it shows an equal amount of character to stick around when a friend becomes despondent and withdrawn.

To all those suffering with depression, I urge you to ask for help sooner rather than later; there is no shame in it. Swallow your pride now and you will come out of it a stronger person.

To everyone who knows someone with depression, please don’t take their distance personally. Even if it doesn't seem like it, your friendship is helping them. Sometimes having someone to help you make a blanket fort and eat ice cream with does more well than all the antidepressants in the world.